Korean Circ J.  2002 Mar;32(3):271-274. 10.4070/kcj.2002.32.3.271.

A Case of Three Major Coronary Arteries to Left Ventricular Fistulae via Common Channel

• Lee CK
• Jeong WJ
• Kim NH
• Sohn IS
• Hwang HK

• KMID: 1938909
• DOI: http://doi.org/10.4070/kcj.2002.32.3.271

Abstract

Multiple coronary arteries to communicating with the left ventricular fistulae is a very rare congenital anomaly in adults. This anomaly involves three major coronary arteries that have a direct communication between these arteries and the left ventricle. Hemodynamically, it induces myocardial ischemia due to coronary steal syndrome and diastolic volume overload from a left-to-left shunt. A 70-year-old woman with essential hypertension was admitted to our clinic to evaluate complaints of exertional dyspnea. Clinical examination revealed a diastolic murmur at the apex. A coronary angiogram showed a common fistular channel connecting the right coronary artery, the left circumflex coronary artery, and the first large diagonal branch of the left anterior descending coronary artery with the left ventricular chamber. The patient's symptoms were relieved by the administration of calcium channel blocker and angiotensin II receptor blocker. We report a very rare case of three major coronary arteries communicating to the left ventricular fistulae via a common channel.

Keyword

Coronary vessel anomalies; Fistula

MeSH Terms

Adult
Aged
Arteries
Calcium Channels
Coronary Vessel Anomalies
Coronary Vessels*
Dyspnea
Female
Fistula*
Heart Murmurs
Heart Ventricles
Humans
Hypertension
Myocardial Ischemia
Receptors, Angiotensin
Calcium Channels
Receptors, Angiotensin